Dodging The Mucus Bullet

[Joe V]

I heard a joke one time, "How can you tell a Nurse from a respiratory therapist? Stand them both in stool up to their chests and throw sputum at them. The one who ducks is the nurse." We all learn in our Nursing programs how to do trach care. Ducking at the right time, however, is a self-taught response. Can you relate? Has this happened to you? Share your nursing stories

[JBMmom, MSN, NP]

Not mucus, but, we had a patient who had an ostomy fail and developed necrotic bowel. For a period of time before a new site could be placed, her bowel just ended in her abdomen and there was a drain to suction. As I went to replace the suction canister there was a malfunction somewhere and the top of the canister exploded off at a high rate of speed, followed by most of the contents of the canister, landing mostly on my face and chest. It was the only time I ever considered just leaving for the night. Fortunately, I had a spare pair of scrubs and I used some hospital towels to wash my face- they could cover that laundry. And all the bleach spray I could find on my glasses. I approach suction canisters much more carefully now. I still don't understand based on physics how that happened, since the suction pulls contents in, not out. But I don't plan to recreate the scenario. 

[kbrn2002, ADN, RN]

We had a long time resident in LTC with a trach. The quickest way for her to clear a mucus plug was to get her laughing and stand back before the offending snot was cleared in God knows what direction.  She was fortunately able to clear it herself 99% of the time, especially if you encouraged her to try to aim at a particular staff member.  Talk about taking one for the team!

[nursel56]

15 hours ago, kbrn2002 said:

We had a long time resident in LTC with a trach. The quickest way for her to clear a mucus plug was to get her laughing and stand back before the offending snot was cleared in God knows what direction.  She was fortunately able to clear it herself 99% of the time, especially if you encouraged her to try to aim at a particular staff member.  Talk about taking one for the team!

I can just see that in the Care Plan! The one trach patient I had who could potentially do this had a very weird sense of humor, so you'd have to specify which jokes get laughs ad which get eye-rolls. ?

@JBMmom -- I will never unsee that and I don't get the mechanics of the catastrophe, either. If it was airborne trach mucus we could ask a respiratory therapist, and likely they would know the answer.

[guest1163268]

On 7/19/2021 at 8:47 AM, JBMmom said:

Not mucus, but, we had a patient who had an ostomy fail and developed necrotic bowel. For a period of time before a new site could be placed, her bowel just ended in her abdomen and there was a drain to suction. As I went to replace the suction canister there was a malfunction somewhere and the top of the canister exploded off at a high rate of speed, followed by most of the contents of the canister, landing mostly on my face and chest. It was the only time I ever considered just leaving for the night. Fortunately, I had a spare pair of scrubs and I used some hospital towels to wash my face- they could cover that laundry. And all the bleach spray I could find on my glasses. I approach suction canisters much more carefully now. I still don't understand based on physics how that happened, since the suction pulls contents in, not out. But I don't plan to recreate the scenario. 

Vacuum.... Suction! Lid off..... Atmosphere. Explosive sound... Build up of air rushing to escape carrying the kaka????????????

Was Rudi Guilliaini present? He's notorious for gaseous emanations ??????????